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  3. 19. Functional Outcome of Fasciocutaneous Flap Used for Soft Tissue Coverage For Open Tibia Fracture (Gustilo Type IIIB), Remote Area Hospital of Pakistan Experience
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19. Functional Outcome of Fasciocutaneous Flap Used for Soft Tissue Coverage For Open Tibia Fracture (Gustilo Type IIIB), Remote Area Hospital of Pakistan Experience

Abbas Memon1, Faheem Ahmed Memon1, and Niaz Hussain Keerio2

ABSTRACT

Objective: To study the role fasciocutaneous flap as a method of soft-tissue reconstruction in Gustilo type IIIB open tibia  fractures, LUMHS experience.

Study Design: Observational study.

Place and Duration of Study: This study was conducted at the Department of Orthopaedics, Liaquat Medical University Hospital, Hyderabad/Jamshoro from 18th Aug 2015 to 18th Jan 2016.

Methods: A total of 49 patients with open tibia fractures (type IIIB) were selected for this study. Patients were operated using a standard prescribed surgical technique. The quantitative variables were described by mean ±SD. The qualitative variables were presented by frequency and percentage. Effect modifiers were controlled by stratification. Chi-square test was applied post stratification and p-value ≤0.05 was considered as significant.

Results: Mostly young patients were involved in the tibia bone fracture with  the mean age of the cases was 38.4years. Major cause of injury was road traffic accidents 32(65.3%). Anatomically leg was divided in three parts, proximal open tibia  fracture were found in 15(30.6%) cases, middle in 20(40.8%) cases and distal in 14(28.6%) cases. Rotational pattern of fasciocutaneous flap was applied in majority of the cases 31(63.3%), while Random pattern fasciocutaneous was used in 11(22.4%) cases and Cross-leg fasciocutaneous was used in 07(14.3%) cases. According to the complications superficial infection was found  in 05(10.20%), followed by Tenderness, Pintact infection, Deep infection, and Marginal Necrosis were found with percentage of 04(8.16%), 02(4.8%), 02(4.8%) and 01(2.4%).External fixation was applied in all the cases and union was found in 42(85.71%) of the cases, while malunion, nonunion, Muscle wasting, Knee stiffness and Ankle stiffness were found with percentage of 05(10.20%), 02(4.8%), 05(10.20%), 08(16.32?%) and 06(12.24%).

Conclusion: Fasciocutanous flap is best option to cover open tibia fracture specially gustillo type III B. It helps to achieve a safe and early durable coverage, avoid nosocomal infection and optimize the healing and facilitate the future reconstruction. The benefit of fasciocutaneous flap is that  they have their own blood supply producing a good durable cover.

Key Words: Functional Outcome,  Fasciocutaneous flap, Open tibia fracture, Gustilo type IIIB.

Citation of article: Memon A, Memon FA, Keerio NH. Functional Outcome of  Fasciocutaneous  Flap  Used  For  Soft Tissue Coverage  For Open Tibia Fracture  (Gustilo  Type IIIB),  Remote Area  Hospital of Pakistan Experience. Med Forum 2017;28(3):71-74.